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Eating disorders. For being one of the most common diseases faced by women and men today and one that has affected women in greater numbers, it is among the most misunderstood. We speculate about who we think has one. We offer simplistic problem-solving advice to friends who may suffer from them. Some even think all it takes is a milkshake a day to keep a recovering anorexic person on the wagon.

But the reality of eating disorders is far less simple.

Here are just five commonly misunderstood truths about the mental and physical ailments that so many Americans suffer from, and our hope is that if we better understood the problem, we could make our world one in which it is less prevalent.

01. Eating disorders can develop even from well-intentioned eating choices.

As one woman who suffers from anorexia nervosa told Verily, what started out as well-intentioned eating choices turned into a devastating illness. She thought she was just calorie counting and avoiding that unnecessary cookie here and there, until her freshman year in college when she had to receive medical treatment. Maggie Niemiec wrote, “It was the perfect storm of factors: a desire to eat healthy, fear of failure, stress about my body, longing for affirmation, isolation from my friends, and a great memory for calories/nutritional information/diet tips. Before I knew it, 'healthy eating' became restriction and then full-blown anorexia nervosa.”

In an article for Broadly last year, nutritional therapist Dr. Karin Kratina said the rates of an obsession with clean eating called orthorexia are rising. “There is nothing wrong with eating local or being a vegetarian or vegan,” Kratina said. “I think a lot of those diets are inherently valuable. The problem is that we have moralized eating, weight, food, and exercise. Food has become presented—more and more—as the answer.”

02. Eating disorders can also be influenced by media we consume.

With super-thin models on display in most of the imagery we consume, some people develop eating disorders after simply spending years breathing the cultural air around us in advertisements and media.

Teens today see nearly 5,000 advertisements a day. Victoria’s Secret advertises “the perfect body” and employs women who have to literally starve themselves to get the desired look before walking the famous Victoria’s Secret Fashion Show. It’s gotten so bad that France has lobbied to outlaw images of über-thin women because of the dangerous public health messaging.

Padma Lakshmi, host of Top Chef, recently shared her experience growing up in the modeling industry. As someone who says her looks have completely to do with her genetics, she has developed mixed feelings about the efforts girls go to when they try to replicate the same look. “A lot of young girls look at those magazines, and they think that’s how they need to be. . . . So I suffered a lot of guilt and mixed feelings about how I had made my living,” Lakshmi confesses. “It’s not an accident that 95 percent of people who suffer from anorexia are women.”

03. Eating disorders are major mental health issues.

Once someone develops an eating disorder, accident or not, it’s with them for the rest of their lives. It’s something like alcoholism in that no matter how many years one is sober of dangerous substances or behavior, they still have to be committed to their recovery for the rest of their lives.

I don’t know if it’s because they’re often associated with teen girls, but eating disorders somehow seem to be taken less seriously than other mental health issues. Let there be no mistake: Eating disorders are very grave mental health issues that require the utmost care and attention. As Jena Morrow shared her personal struggle with anorexia with Verily, she said, “I’ve spent years both on the wagon and off. I’ve been sick, hospitalized, better, almost well, sick again, in treatment, better, etc. I’ve befriended amazing women—and a few young men—who share my struggle. I’ve loved them, fought with them, watched some of them get better, get well, get married, have children. I’ve watched others get sick, get sicker still, and die.” It is by no means an easy issue to get through, and this brings us to another often missed reality about eating disorders.

04. Eating Disorders can be life-threatening.

Eating disorders have the highest mortality rate of any mental illness. In fact, 5 to 20 percent of those who suffer from anorexia will die prematurely as a result of the disease. Sometimes the threats aren't obvious. They're happening internally. According to the National Eating Disorder Association, anorexics can suffer extreme dehydration, which can lead to kidney failure. They also tend to have slower heart rates and lower blood pressure and can be at risk for heart failure. The extreme risks associated with all types of eating disorders are many. 

As it happens, twenty-four million Americans of all ages and genders suffer from an eating disorder, yet only one in ten sufferers get help.

05. It’s important to be intentional in how you talk to someone who has an eating disorder.

People who have eating disorders need support from friends to get the help they need, but too often people don’t understand the uniqueness of the disorder or the gravity of what the person is going through. Often, compliments like "you look great to me" or "there’s nothing wrong with your looks" don’t ease the mind of someone with an eating disorder. Instead, a friend should plan how to approach their friend very carefully: Set aside a time to speak with your friend alone, make time to listen, and ask him or her specific questions. Ask how she’s doing, invite her over for dinner, admit that you too have your own struggles, and most of all remind her that you don’t love her any differently for what she’s going through. Overall, remember that it’s not as simple as you may initially have thought.

Here’s hoping that with these things in mind, we can all be better friends to our loved ones and ourselves, no matter what challenges we may be going through.

Photo Credit: Hedda Selder